• Coding Data Quality Auditor

    CVS Health (Madison, WI)
    …to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... job experience equal to approximately 1-2 years for CPC. + CPC ( Certified Professional Coder) or CCS-P ( Certified Coding Specialist-Physician) required.… more
    CVS Health (08/09/25)
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  • Hospital Coding Specialist III (Remote)

    Marshfield Clinic (Marshfield, WI)
    …Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG ( Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related ... related to the position_ **Minimum Required:** Active credential of Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or… more
    Marshfield Clinic (08/01/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (WI)
    …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... excellent problem-solving skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting,… more
    Molina Healthcare (07/31/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Madison, WI)
    …Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible ... + Previous leadership/people management experience + PBM/health care experience + Certified Compliance and Ethics Professional (CCEP) or Certified Healthcare… more
    Prime Therapeutics (07/25/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Green Bay, WI)
    …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... Any one or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + … more
    Molina Healthcare (08/15/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Madison, WI)
    …or CERTIFICATIONS** **Required** + None **Preferred** **(Any of the Following)** + Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + ... Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance (CHC) + Certified ...and cross-functional strategy development. + Experience with managed care, Medicare and federal and/or state regulations, quality improvement and… more
    Highmark Health (07/29/25)
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  • Nurse Navigator - Oncology

    Marshfield Clinic (Marshfield, WI)
    …of hire or within six months of qualification. **Preferred/Optional:** + Oncology Certified Nurse (OCN) awarded by the Oncology Nursing Certification Corporation. + ... Blood and Marrow Transplant Certified Nurse (BMTCN) certification awarded through the Oncology Nursing...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
    Marshfield Clinic (06/12/25)
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  • Survivorship Program Nurse Coordinator

    Marshfield Clinic (Marshfield, WI)
    …of hire or within six months' of qualification. **Preferred/Optional:** + Oncology Certified Nurse (OCN) awarded by the Oncology Nursing Certification Corporation. + ... Blood and Marrow Transplant Certified Nurse (BMTCN) certification awarded through the Oncology Nursing...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
    Marshfield Clinic (06/05/25)
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  • Emergency Medical Technician - Basic or Advanced…

    Marshfield Clinic (Park Falls, WI)
    …acceptable to MCHS's insurer. + Emergency Vehicle Operations Certification (EVOC), Certified Emergency Vehicle Operator (CEVO), or Emergency Vehicle Driver Training ... at the time of hire. + Emergency Vehicle Operations Certification (EVOC), Certified Emergency Vehicle Operator (CEVO), or Emergency Vehicle Driver Training (EVDT) at… more
    Marshfield Clinic (06/04/25)
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  • Physician - Pediatric Neurology

    Marshfield Clinic (Marshfield, WI)
    …with the latest technology, more than 40 pediatric specialties and board- certified pediatric hospitalists, intensivists, and neonatologists. Certified child life ... with the latest technology, more than 40 pediatric specialties and board- certified pediatric hospitalists, intensivists, and neonatologists. Certified child life… more
    Marshfield Clinic (08/20/25)
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